Surgical FAQs

What’s the Difference Between an Excision and Mohs Surgery?

Both excisions and Mohs surgery are procedures used to remove skin cancers, but they differ in how the tissue is removed and examined.

Standard Excision

In a traditional excision, the visible tumor and a margin of surrounding normal skin are removed. The tissue is sent to an outside laboratory for processing and review by a pathologist, with results typically available several days later.
An excision is often used for less aggressive skin cancers or areas where tissue preservation is less critical.

Mohs Micrographic Surgery

Mohs surgery is performed in stages on the same day. After each thin layer of tissue is removed, it is processed and examined under a microscope in our office laboratory by Dr. Freedman.

The tissue is mapped in detail so that if any cancer cells remain, only those specific areas are re-excised. This precise technique allows complete margin evaluation while sparing as much healthy skin as possible, making it ideal for the face, scalp, ears, and other cosmetically or functionally important areas.

How long will the procedure take?

Most Mohs surgeries are completed within a few hours, but the exact time varies. Each stage of tissue processing can take 45–60 minutes. Some patients need only one stage; others require several. Please plan to be with us for most of the day, just in case.

Can I eat or drink before surgery?

Yes — unless you’ve been instructed otherwise by your physician. We recommend eating a normal breakfast and bringing a snack or drink since the process can take several hours. Don’t overdue to caffeine that day.

Should I take my regular medications?

Generally, yes. Continue your usual medications unless you have been told to stop a specific one.
If you take blood thinners (like aspirin, Plavix, Eliquis, Xarelto, Pradaxa, Brilinta, or warfarin), do not stop them unless cleared by your prescribing doctor. The increase in bleeding risk is preferable to the risk of a serious clot.

What should I wear?

Wear comfortable, loose-fitting clothing that allows easy access to the surgical site. Avoid makeup, lotions, or jewelry near the area being treated. Bring a warm layer as the surgical rooms are kept a bit colder than the others.

Can I drive myself home?

It depends on the surgical site and whether we use certain medications. Many patients drive themselves, but if your surgery is around the eyes, requires sedation, or if you take anxiety medicines for the procedure, arrange for a driver.

What happens after the cancer is removed?

Once the skin cancer has been fully removed, Dr. Freedman will discuss the best reconstruction method — such as a layered closure, skin flap, or graft — depending on the size and location of the wound. Most repairs are done the same day.

Will it hurt?

You’ll be numbed with local anesthesia during the procedure and should feel pressure, not pain. Mild soreness or tightness afterward is common and managed with over-the-counter pain relievers like acetaminophen.

How do I care for the wound at home?

You’ll receive written instructions for wound care before leaving. In general, this involves keeping the area clean, applying ointment, and changing the dressing once or twice a day.
We’ll schedule a follow-up visit to check healing and remove stitches if necessary.

When can I resume normal activities?

Avoid activities which might increase your heart rate or blood pressure for a day or two. Avoid strenuous activity, bending, or heavy lifting for at least 1–2 weeks (depending on the site, some specific areas require longer). Gentle daily activities are usually fine.

When will I be able to return to work?

Do not plan to go to work the same day as your surgery. You may be able to return to work a day or two after, depending on the part of your body affected, and the type of job you perform. Some parts of your body, such as areas below the knees, may require you to be off your feet for a bit depending on the type of closure performed. These are great questions to ask at a consultation visit before the surgery so you can plan accordingly.

Will I have a scar?

Any skin surgery leaves a scar, but Mohs surgery minimizes its size. Dr. Freedman specializes in precise closures and careful alignment of skin lines to make the scar as inconspicuous as possible.

When will I get my results?

With Mohs surgery, you receive your results the same day — you’ll leave knowing the skin cancer has been completely removed. For standard excisions, results are typically available within a few business days.